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REGION OF PEEL Urban Form Health Assessment Tool APHA Annual Meeting: Public Health Without REGION OF PEEL Urban Form Health Assessment Tool APHA Annual Meeting: Public Health Without Borders October 28, 2008 Gayle Bursey, RD, BASc, MES, Director Bhavna Sivanand, MPH, Project Specialist Division of Chronic Disease and Injury Prevention Region of Peel Public Health

PRESENTER DISCLOSURES GAYLE BURSEY & BHAVNA SIVANAND The following personal financial relationship with commercial PRESENTER DISCLOSURES GAYLE BURSEY & BHAVNA SIVANAND The following personal financial relationship with commercial interests relevant to this presentation existed during the past 12 months: NO RELATIONSHIPS TO DISCLOSE

OUTLINE 1. Overview of Peel 2. Peel Health Statistics 3. Conceptual model: Health and OUTLINE 1. Overview of Peel 2. Peel Health Statistics 3. Conceptual model: Health and Built Environment 4. Political Background to Project Initiation 5. Urban Form Health Assessment Tool 6. Tool Implementation and Policy Next Steps

REGION OF PEEL: GREATER TORONTO AREA REGION OF PEEL: GREATER TORONTO AREA

PEEL: BRAMPTON, CALEDON, MISSISSAUGA Rapid Growth – 1. 5 million by 2031 Uneven Growth PEEL: BRAMPTON, CALEDON, MISSISSAUGA Rapid Growth – 1. 5 million by 2031 Uneven Growth – Brampton, Mississauga Unique Challenges - greenfield (Brampton) - intensification (Mississauga) - rural (Caledon) Population growth from 2001 -2006 in these areas was 51% to 2383% • more vehicle trips • increasingle occupant vehicle trips • increasing physical inactivity levels

INACTIVITY BY BMI: PEEL & ON PEEL INACTIVITY BY BMI: PEEL & ON PEEL

DIABETES PREVALENCE: PEEL & ON PEEL DIABETES PREVALENCE: PEEL & ON PEEL

COMPLEX SET OF FACTORS AFFECT URBAN FORM COMPLEX SET OF FACTORS AFFECT URBAN FORM

OBESITY PREVENTION NEEDS BEHAVIOUR CHANGE Obesity prevention messages are ineffective if not within supportive OBESITY PREVENTION NEEDS BEHAVIOUR CHANGE Obesity prevention messages are ineffective if not within supportive environments Individual Messaging Supportive Environments • To increase physical activity • To increase nutritious food intake • Built environment • Food environment

SUPPORTIVE ENVIRONMENTS Supportive environments ENABLE preferred behaviour FOOD ENVIRONMENT BUILT ENVIRONMENT • • Small SUPPORTIVE ENVIRONMENTS Supportive environments ENABLE preferred behaviour FOOD ENVIRONMENT BUILT ENVIRONMENT • • Small portions Availability Food culture Dining as an experience • Buy fresh, buy local as the social norm Proximity Connectivity Pleasant streetscape Active transportation culture • Transportation hubs and options

PLANNING AND HEALTH: THE LINK Recent increase in academic and practice-based evidence about the PLANNING AND HEALTH: THE LINK Recent increase in academic and practice-based evidence about the health impacts of land use development patterns • Ontario Healthy Communities Coalition (OHCC) • Ontario College of Family Physicians (OCFP) • Heart and Stroke Foundation of Canada • Canadian Institute for Health Information (CIHI) • Ontario Professional Planners Institute (OPPI) • Canadian Urban Institute (CUI)

PLANNING AND HEALTH: THE LINK OPPI has identified 5 areas of research: 1. How PLANNING AND HEALTH: THE LINK OPPI has identified 5 areas of research: 1. How do the built environment and transportation systems contribute to obesity and related health issues? 2. How do the built environment and transportation systems affect air quality along heavily travelled corridors and in areas of mixed uses and higher densities? 3. How do the built environment and transportation systems affect air quality in general? 4. How do the built environment and transportation systems, along with poverty and economic decline within and outside our major urban centres, affect human health? 5. How do the built environment and transportation systems affect social cohesion?

DEPARTMENT OF PUBLIC HEALTH AT PEEL POLITICAL BACKGROUND • Council Report (2005) called: State DEPARTMENT OF PUBLIC HEALTH AT PEEL POLITICAL BACKGROUND • Council Report (2005) called: State of the Region’s Health: Focus on Overweight, Obesity and Related Health Consequences in Adults - joint report with ETPS and Health - highlighted impact of built environment on health

DEPARTMENT OF PUBLIC HEALTH AT PEEL • Council Resolution (GC-257 -2005): • Health staff DEPARTMENT OF PUBLIC HEALTH AT PEEL • Council Resolution (GC-257 -2005): • Health staff to comment on any development applications that come into the Region for comment • Study and make recommendations for planning policies and processes that provide greater opportunity for active living • Advocate for policies which strengthen public and active transportation options

PEEL HEALTH INITIATIVES 1. Literature Review 2. Peel Health Position Statement 3. Conceptual Models PEEL HEALTH INITIATIVES 1. Literature Review 2. Peel Health Position Statement 3. Conceptual Models 4. Mississauga Urban Form Committee 5. Active Transportation Initiative a. Social Marketing b. Infrastructure Plan 6. Comments on Municipal Block Plans 7. Urban Form Health Assessment Tool

Urban Form Health Assessment Tool Lawrence Frank, B. L. Arch, M. Sc. , Ph. Urban Form Health Assessment Tool Lawrence Frank, B. L. Arch, M. Sc. , Ph. D Bombardier Chair, Sustainable Transportation, UBC President, Lawrence Frank and Company James R. Dunn, Ph. D Research Scientist, Center for Research on Inner City Health Associate Professor, Dep’t Geography and Public Health, U of T

Urban Planning & Public Health: The Evidence Lawrence Frank – Seattle Study: A 5% Urban Planning & Public Health: The Evidence Lawrence Frank – Seattle Study: A 5% increase in walkability is associated with: • a 32% increase in minutes walking • a ¼ point reduction in BMI (about ½ kilogram) • a 6. 5% reduction in per capita vehicle kilometers travelled • a 5. 5% reduction in ozone precursors Lawrence Frank – Atlanta Study: • additional 30 minutes driving/day 3% increased risk of obesity • additional km walked/day 4. 8% reduction in risk of obesity

Urban Planning & Public Health: The Evidence Other Research: • Every 10 additional minutes Urban Planning & Public Health: The Evidence Other Research: • Every 10 additional minutes spent in the car 10% drop in community involvement • Rates of overweight and obesity are lower in urban cores compared to suburban areas • Canadians living in major urban centers are twice as likely to walk, bike or use transit to get to work • Motorist and pedestrian injury rates are associated with environmental factors (e. g. road design, traffic congestion)

BUILT ENVIRONMENT FEATURES & HEALTH DENSITY MIXED LAND USE AESTHETICS CONNECTIVITY BUILT ENVIRONMENT FEATURES & HEALTH DENSITY MIXED LAND USE AESTHETICS CONNECTIVITY

HEALTH ASSESSMENT TOOL : WHAT Developing an evidence-based prototype Health Assessment Tool that would HEALTH ASSESSMENT TOOL : WHAT Developing an evidence-based prototype Health Assessment Tool that would systematically identify the public health impact of built environments in Peel Goals: • Promote the development of healthier built environments in Peel • Increase the Walkability of Peel neighbourhoods to promote active living by design

HEALTH ASSESSMENT TOOL : HOW DATA LAND USE VARIABLES: • • • Parks and HEALTH ASSESSMENT TOOL : HOW DATA LAND USE VARIABLES: • • • Parks and Trails Transit routes/schedules/stops Greenspace Sidewalk Attribution Census information (demographic, income, HH size) Postal code polygons Building Square Footage Property Assessment Parcels Street Networks (signalized intersections) Traffic Zone Data HUMAN DATA: • • Physical Activity Sedentary Activity Leisure Activity Obesity Chronic Conditions Stress Mode of travel to work Public Transit Use

HEALTH ASSESSMENT TOOL : HOW LAND USE VARIABLES le op Pe gs in uild HEALTH ASSESSMENT TOOL : HOW LAND USE VARIABLES le op Pe gs in uild B ets e Str TRAVEL PATTERNS alit Re WALKABILITY SURFACE y HEALTH OUTCOMES

HEALTH ASSESSMENT TOOL : HOW WALKABILITY SURFACE (Reality of Walkability at Peel) Demographic Information HEALTH ASSESSMENT TOOL : HOW WALKABILITY SURFACE (Reality of Walkability at Peel) Demographic Information (Census) Street Previously established statistical Connectivity relationships between certain urban form elements and walkability Land-use Density Mix WALKABILITY SURFACE with Statistical Weights DATABASE / SPREADSHEET SOFTWARE MODEL

HEALTH ASSESSMENT TOOL : HOW Software Model Requirements: 1. Ability to evaluate land development HEALTH ASSESSMENT TOOL : HOW Software Model Requirements: 1. Ability to evaluate land development alternatives 2. Ability to evaluate at a relatively small scale (neighbourhood) 3. Flexibility to incorporate outcomes and land use measures based on research 4. Ability to incorporate health and air quality outcomes

HEALTH ASSESSMENT TOOL : THE MODEL Example: PLACE 3 S 1. Web-based 2. GIS-based HEALTH ASSESSMENT TOOL : THE MODEL Example: PLACE 3 S 1. Web-based 2. GIS-based – Visual Output 3. Flexible 4. Public engagement and collaborative decision making 5. Meets our model requirements for Tool 6. Used in other government settings (California, Seattle)

HEALTH ASSESSMENT TOOL : NEXT STEPS • Pilot testing and Retrofitting • Policy Development HEALTH ASSESSMENT TOOL : NEXT STEPS • Pilot testing and Retrofitting • Policy Development – Official Plans • Regional Official Plan Amendment: • Strengthen health rationale within existing policies • Effective use of Health Assessment Tool • Require health as a background study at the Secondary Plan stage • Developer Incentives/Marketing strategy

For more info… http: //www. peelregion. ca/health/urban Bhavna Sivanand, Project Specialist Region of Peel For more info… http: //www. peelregion. ca/health/urban Bhavna Sivanand, Project Specialist Region of Peel Public Health bhavna. [email protected] ca